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Telehealth. DPS Lecture – Healthcare 2020.

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DPS Lecture – Healthcare 2020


An exciting new area for disruptive innovation is likely to come from a focus on holistic patient care with an emphasis in life-long well-being. The convergence of medical and information technologies will be facilitated by a much more informed patient population that will expect much more than a pill. They will expect an integrated patient solution that will address the underlying disease and improve their life.

Miguel Barbosa, Ph.D, VP at Janssen Research &Development – PharmaVoice March 2013

Patients are becoming smarter, expect higher quality care, and will be more conscious about health decisions they make.

  • 13+ years Life Sciences experience
    • Director, R&D Customer Success at Veeva
    • Enterprise Program Director at NextDocs
    • Head of Global Regulatory Systems at Genzyme
  • Passionate about the future of Health Care
    • Future of Clinical Trials and Regulation
    • Transforming Life Sciences IT
    • Patient Engagement and Behavioral Change
    • Mobile Technology


P: 781-375-8070


  • Telehealth – Definitions and Key Concepts
  • Health Care 2020
  • Trends – Opportunities and Barriers
  • Examples
  • AMAA

“The use of digital technologies to deliver medical care, health education, and public health services, by connecting multiple users in separate locations.

Telehealth services consist of diagnosis, treatment, assessment, monitoring, communications, and education. It includes a broad range of telecommunications, health information, videoconferencing, and digital image technologies.”

- The Center for Connected Health Policy

  • Telehealth services have been traditionally delivered in three main ways:
    • • Video conferencing
    • • Remote patient monitoring
    • • Store & forward technologies
is a lot more than just telehealth
Is a lot more than just Telehealth….
  • Telemedicine is the delivery of health care services by providers with the intention of providing diagnosis, treatment and prevention, research and evaluation, and continuing education.
  • mHealth is the use of mobile-based (smart phones, etc..) applications in health care.
  • eHealth is the use of internet-based (or internet accessible) applications in health care.
spectrum of telehealth
Spectrum of Telehealth

Clinical Telehealth

Consumer Telehealth

Focused on the wellness and preventive aspect of healthcare.

Unlike the clinical side, these services and products are more standardized and less regulated, with ease of use being paramount.

  • Telehealth is used to replace or add to existing clinical services that plan to diagnose and/or treat patients.
  • These services are typically highly customized and regulated, and the scrutiny of information and outcomes is quite high.
telehealth is simultaneously broadening and focusing the health care industry
Telehealth is simultaneously Broadening and Focusingthe health care industry

Capabilities, Applications, Solutions, Reach

Protocols, Technologies, Standards, Best Practices

the patient
The Patient


the system
The System

Health Care is now primarily PROACTIVE vs REACTIVE

specific consumers are most influential
Specific consumers are most influential

Source(s): Pew Internet Research, 2013

a necessity for the future of life sciences companies
A necessity for the future of life sciences companies

Emotional Branding

As life sciences companies adopt a patient centric model, they need to differentiate themselves on value, not on the medicine itself. This is most relevant in highly competitive spaces such as diabetes or cholesterol therapies.

Telehealth will enhance the connection between patient and provider, helping to improve the collection of data to optimize therapies, and strengthen the connection between companies and consumers.

health information is disconnected
Health Information is Disconnected
  • There should exist a standardized infrastructure to enable a regional, and national environment for connected health information.
  • The lack of standards and interoperability among systems makes widespread connectivity difficult, impeding clinician access to real-time data for medical decision-making.
    • If a patient walks across the street to a different hospital, there is a high likelihood that his or her care will start from the ground up, as any documentation from another system would be inaccessible.
big data big growth
BIG Data = BIG Growth
  • 425k health providers in the US
  • 36.6M, 2011 admissions to registered hospitals according to the American Hospital Association.

Medical image archives to increase by 20-40% a year

Today 80% of data is unstructured.

Source: MedCity News

big data big opportunity
BIG Data = BIG Opportunity
  • By 2015 the average hospital will generate 665TBa year.
  • By 2020 the amount of worldwide health care data is expected to grow to 50 times the current total to 25,000 petabytes
      • Clouds roll in to handle stratospheric capacity needs, Healhcare IT News, October 2011

Source: MedCity News

mindsets need to change
Mindsets Need to Change
  • The industry is focused on face-to-face care based only on tradition and fragmented delivery systems where real-time collaboration is impossible.
  • Coordination of care among diagnostic and therapeutic providers, inpatient and outpatient facilities and home care environments is unacceptably low – as is payer reimbursement for this level of interaction.
  • Providers today wrestle with financial, regulatory and operational challenges.
everyone is involved in facilitating change
Everyone is involved in facilitating change
  • Companies must prove the benefits of their innovations in terms of health outcomes and economic benefits.
  • Policy makers and politicians need to ensure that regulations support future innovation.
  • Health care providers will have to focus on delivering services outside the hospital setting.
  • Payers need to provide reimbursement that reward innovation.
  • Patients need to take a more active role in managing their own health.
a note on privacy
A Note on Privacy
  • If you are on Medicare or Medicaid, the government has your medical records.
  • Private payers have HUGE databases with your medical records.
  • EHR companies and pharmacies have your medical records.
  • Your data is being constantly de-identified, sold, re-identified and used to create new health care services for financial profit.
  • Once HIE’s officially become a reality, State and private agencies will also begin building their own repositories of medical records.
examples of innovation
Examples of innovation
  • Intelligent Pills Deliver Medication to Specific Locations: Philips Research has developed an intelligent pill that can be programmed to deliver targeted doses of medication to patients with digestive disorders such as Crohn’s disease, colitis, and colon cancer.1
  • Sensor Technology Tracks Medication Adherence: Proteus Biomedical is working on technology that incorporates a tiny sensor into pills for targeting medication adherence for organ transplants, cardiovascular disease, infectious diseases, diabetes, and psychiatric disorders.2
  • Printing New Skin: Wake Forest University’s scientists have discovered how to apply ink-jet printer technology to ‘print’ proteins directly onto a burn victim’s body for faster and more thorough healing.5
  • Video Games Hone Medical Student Decision-Making Skills: The University of Texas, Corpus Christi, and BreakAway Ltd., have developed a ‘serious’ video game that lets professionals and students practice on 3D video patients using the same interactive techniques and decision-making processes they would use with real patients.
  • Robot Care Givers: MIT’s “Huggable” teddy bear robot can serve as a medical communicator for children. Packed with electronic sensors and sensitive skin technologies, the robot can distinguish between cuddling for comfort or agitation by sensing the strength of the squeeze.7
continuous professional education
Continuous Professional Education
  • QuantiaMD
  • Website and mobile app that hosts interactive presentations on clinical and medical practice management.
  • 500 QuantiaMD expert faculty members, who include physicians from academic institutions, group practices, and community medical centers.
  • 160,000 registered users.
patient communities
Patient Communities
  • PatientsLikeMe
  • Patient network to connect patients with others who have the same disease or condition and track and share their own experiences.
  • Goal is to accelerate clinical research, improve treatments and patient care
  • PatientsLikeMe research team has authored more than a dozen peer-reviewed published scientific articles
  • Sells aggregated, de-identified data to pharmaceutical companies and medical device makers.
  • 200,000 + registered users.
clinical trials in a box
Clinical Trials in a Box
  • A patient walks into a doctor’s office
    • EMR tells doctor patient meets inclusion/exclusion criteria for trial
    • Doctor gives patient a box of validated medical devices
    • Connected Medical Devices
    • Patient Portal
    • CCR/CCD or Blue Button or HealthVault connectivity
  • Patient remains engaged with trial, gets better data
the phr uhr problem
The PHR/UHR Problem
  • Evolving standards and frameworks….like CCR/CCD and BlueButton
  • A few dominant players….like Microsoft HealthVault and Dossia.
  • Challenges?
  • Opportunities?
emr ehr data mining
EMR/EHR Data Mining
  • Tremendous potential for the future of clinical trials, evidence based care, and public health.
  • Challenges?
  • Opportunities?
event driven technology
Event Driven Technology
  • Technology helps providers connect, correlate, understand, and act upon information across systems,
  • Improves the coordination and visibility of patient care, gaining efficiencies, and reducing waste.
  • Real-time, event driven platforms enable provider organizations to manage massive volumes of data to:
    • Identify potential problems faster
    • Intervene proactively
    • Influence clinical and financial outcomes